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Al Attar WSA, Mahmoud H, Alfadel A, Faude O. Does Headgear Prevent Sport-Related Concussion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials Including 6311 Players and 173,383 Exposure Hours. Sports Health 2024; 16:473-480. [PMID: 37204092 PMCID: PMC11025511 DOI: 10.1177/19417381231174461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
CONTEXT A sport-related concussion (SRC) is a traumatic brain injury that is caused by biomechanical stresses and results in a complex pathophysiological process in the brain. Some in the sporting community believe that headgear (HG) can prevent SRC, and several professional Australian sports organizations, including rugby, football, and soccer clubs, recommend its use. OBJECTIVE The purpose of this study is to determine whether HG is effective in lowering the prevalence of SRC in sports. DATA SOURCES A systematic search for related studies published between 1985 and 2023 was conducted using the following databases: Cochrane Library, AMED, PubMed, Web of Science, and Physiotherapy Evidence Database (PEDro). STUDY SELECTION Only randomized controlled trials (RCTs) that investigated the effectiveness of HG in reducing SRC rate were included. STUDY DESIGN Systematic review and meta-analysis of RCTs. LEVEL OF EVIDENCE Level 1a. DATA EXTRACTION Two researchers independently completed the title and abstract search and performed full-text reviews. A third reviewer was consulted to reach a consensus if any discrepancies were noted. The PEDro scale was used to evaluate the quality of the included RCTs. Data recorded from each study included authors, year of publication, type and number of players, study design, duration of the study, injury rate, compliance (%), sports/level, and exposure hours. RESULTS The pooled results of 6311 players and 173,383 exposure hours showed 0% SRC reduction per 1000 hours of exposure in the experimental group compared with the control group, with an injury risk ratio of 1.03 (95% CI, 0.82-1.30; P = 0.79). CONCLUSION This systematic review and meta-analysis demonstrates that HG does not prevent SRC among soccer and rugby players, and therefore the findings from this meta-analysis do not currently support the use of HG to prevent SRC in soccer or rugby.
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Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Hayam Mahmoud
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abdulaziz Alfadel
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy, King Abdul Aziz Medical City, Jeddah, Saudi Arabia
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Al Attar WSA, Husain MA. Effectiveness of Injury Prevention Programs With Core Muscle Strengthening Exercises to Reduce the Incidence of Hamstring Injury Among Soccer Players: A Systematic Review and Meta-Analysis. Sports Health 2023; 15:805-813. [PMID: 37139743 PMCID: PMC10606958 DOI: 10.1177/19417381231170815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
CONTEXT Muscles in the hamstring group are frequently injured in sporting activities. Injury prevention programs (IPPs), including eccentric training of the hamstrings, have proven to be of great value in decreasing the injury rate of hamstring muscles. OBJECTIVE To examine the effectiveness of IPPs that include core muscle strengthening exercises (CMSEs) in reducing hamstring injury rates. DATA SOURCES This systematic review with meta-analysis was based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted for relevant studies published from 1985 to 2021 using the following databases: Cochrane Library, MEDLINE, AMED, PubMed, Web of Science, and Physiotherapy Evidence Database (PEDro). STUDY SELECTION The initial electronic search found 2694 randomized controlled trials (RCTs). After removing duplicate entries, 1374 articles were screened by their titles and abstracts, and 53 full-text records were assessed, of which 43 were excluded. The remaining 10 articles were reviewed in detail, from which 5 studies met our inclusion criteria and were included in the current meta-analysis. STUDY DESIGN Systematic review and meta-analysis of RCTs. LEVEL OF EVIDENCE Level 1a. DATA EXTRACTION Two researchers independently completed the abstract review and performed full-text reviews. A third reviewer was consulted to reach a consensus if any discrepancies were noted. Details were recorded about the participants, methodological aspects, eligibility criteria, intervention data, and outcome measures, including age; number of subjects in the intervention/control group; number of injuries in each group; and the duration, frequency, and intensity of the training conducted in the intervention. RESULTS The pooled results of 4728 players and 379,102 exposure hours showed 47% hamstring injury reduction per 1000 h of exposure in the intervention group compared with the control group with an injury risk ratio of 0.53 (95% CI [0.28, 0.98], P = 0.04). CONCLUSION The results indicate that CMSEs incorporated with IPPs reduce susceptibility and risk of hamstring injuries in soccer players.
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Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Mohamed A. Husain
- Department of Physical Education, College of Health and Sport Sciences, University of Bahrain, Sakhir, Bahrain
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Barrera-Díaz J, Figueiredo AJ, Field A, Ferreira B, Querido SM, Silva JR, Ribeiro J, Pinto I, Cornejo P, Torres H, Saffa A, Sarmento H. Contemporary practices of physical trainers in professional soccer: A qualitative study. Front Psychol 2023; 14:1101958. [PMID: 37799523 PMCID: PMC10548828 DOI: 10.3389/fpsyg.2023.1101958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/10/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Physical trainers (PTs) are integral for managing load, reducing injury and optimizing performance in professional soccer. However, little is known about how this practitioners operate in the applied setting and how some of the nuances experienced influence practice. Methods This study explored the contemporary practices of PTs in professional soccer. Semi-structured interviews were undertaken with eight PTs from different professional teams in European and South American leagues. Interview questions were designed to extract information on the evaluation of physical abilities, monitoring and control of training and injury prevention. Subsequently, the interviews were video-recorded, transcribed, translated and analyzed using a content analysis approach. Results The results suggest that the evaluation of physical capacities is carried out by PTs at the beginning of the preseason. It also appears that it is attempted that this process of regular testing is applied during the competitive period, with most participants conducting partial physiological and physical evaluations at different stages throughout the competitive season. In relation to the monitoring and control of training, subjective feedback scales are used to estimate the internal load, and the use of GPS devices is common to quantify external loads. Injury prevention programmes were implemented by all participants and were generally in a multi-component format focused on preventing or optimizing physical capabilities. Discussion These insights can be used as a scientific reference point to inform applied practice in professional soccer, especially for practitioners that are inexperienced and aspiring to enhance how they operate in the field. Future investigations should explore the practices of PTs in detail and across a wider network in order to gain deeper and comprehensive insights into the applied soccer environment.
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Affiliation(s)
- Joel Barrera-Díaz
- University of Coimbra, Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
| | - António J. Figueiredo
- University of Coimbra, Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
| | - Adam Field
- Department of Sport and Exercise Science, Research Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Bruno Ferreira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior, Portugal
| | - Sérgio M. Querido
- Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada-Dafundo, Portugal
| | - João Renato Silva
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal
| | - João Ribeiro
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia (ISMAI), Maia, Portugal
- Department of Performance Optimization, Gabinete de otimização desportiva, Sporting Clube de Braga SAD, Braga, Portugal
| | | | | | | | - Alvaro Saffa
- Universidad Andrés Bello, Dirección Nacional de Deportes, Santiago, Chile
| | - Hugo Sarmento
- University of Coimbra, Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
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Seyedi M, Zarei M, Daneshjoo A, Rajabi R, Shirzad E, Mozafaripour E, Mohammadpour S. Effects of FIFA 11 + warm-up program on kinematics and proprioception in adolescent soccer players: a parallel‑group randomized control trial. Sci Rep 2023; 13:5527. [PMID: 37016130 PMCID: PMC10073194 DOI: 10.1038/s41598-023-32774-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/02/2023] [Indexed: 04/06/2023] Open
Abstract
This study aimed to compare the effects of 8 weeks 11 + warm-up injury prevention program on kinematics and proprioception in adolescent male and female soccer players. Forty adolescent soccer players (20 males, 20 females) aged between 14-16 years old were randomly assigned into four groups. The experimental group performed the 11 + program for 8 weeks and the control group did their warm-up program. The kinematic variable in a cutting maneuver was measured using VICON motion analysis and ankle and knees' proprioception by joint position sense (JPS) was measured using a digital inclinometer. For kinematic variables only significant differences in knee valgus among females 11 + compared with female and male control groups were found (P < 0.05). Moreover, there were significant improvements in joint position sense variables in 11 + groups compared to control groups (P < 0.05). In conclusion, the 11 + program was proven to be a useful warm-up protocol in improving knee valgus and JPS among female and male adolescent soccer players. We suggest adding more training elements to the 11 + program that aimed to enhance the proper alignment of lower extremities which may consequently improve joint kinematics.
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Affiliation(s)
- Mohammadreza Seyedi
- Department of Sport Medicine, Sport Sciences Research Institute, Tehran, Iran.
| | - Mostafa Zarei
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Abdolhamid Daneshjoo
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport Science, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Reza Rajabi
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Elham Shirzad
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Esmaeil Mozafaripour
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Shadan Mohammadpour
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Asgari M, Nazari B, Bizzini M, Jaitner T. Effects of the FIFA 11+ program on performance, biomechanical measures, and physiological responses: A systematic review. J Sport Health Sci 2023; 12:226-235. [PMID: 35659964 PMCID: PMC10105015 DOI: 10.1016/j.jshs.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/12/2022] [Accepted: 04/22/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND The side effects of the FIFA 11+ program on performance have not been generally reviewed. The objective of this study was to synthesize the literature on the effects of the 11+ on players' performance. METHODS Five online databases (PubMed, Scopus, ScienceDirect, Springer, and Google Scholar) were searched (from April 2006 to March 2022) using predefined keywords and sub-keywords. The potential references were primarily recorded through Endnote and imported to Covidence. Out of the 123 references screened by 2 blinded researchers through the software, 59 full texts were assessed for eligibility, 33 of which were ultimately included. The quality of the studies and the risk of bias were then assessed. Study ID, title, place, aim, design, start/end dates, population description, study criteria, statistical analysis, and outcomes were extracted. RESULTS Studies were conducted on male and female players aged 10-32 years old. The quality of the studies was moderate to high, and except for unclear bias for blinding outcome assessment, the risk of bias for all domains was low. Long-term application of the 11+ improved most biomechanical measures and physiological responses except for lower extremity stability, ankle evertors time latency, ankle dorsiflexion, and proprioception. Conversely, the 11+ showed acute negative effects on physical performance compared to dynamic warm-ups and non-significant effects on technical abilities. CONCLUSION Mid-to-long-term implementation of the 11+ improved the majority of biomechanical and a couple of physical measures but showed no effects on technical skills. Precaution must be observed for using the 11+ before competitions, as it could acutely decrease physical/technical performance. Given the contradictory nature of the literature, further studies should evaluate the short-to-mid-term effects of the 11+. Further studies are required to address ankle responses to the 11+ intervention.
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Affiliation(s)
- Mojtaba Asgari
- Institute for Sport and Sports Science, TU Dortmund University, Dortmund 44221, Germany.
| | - Bahareh Nazari
- Faculty of Physical Education and Sports Science, University of Tehran, Kish Island branch, Kish Island 79416, Iran
| | - Mario Bizzini
- Human Performance Lab, Schulthess Clinic Lengghalde, Zürich 8008, Switzerland
| | - Thomas Jaitner
- Institute for Sport and Sports Science, TU Dortmund University, Dortmund 44221, Germany
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Al Attar WSA, Ghulam H, Al Arifi S, Alomar AI, Alhosaini S, Alharbi S, Alraddadi Y, Sanders RH. Injury prevention programs including balance exercises with compliance and follow-up reduce the incidence of knee injuries in athletes: A systematic review and meta-analysis. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND: The knee is one of the most common injuries in sports. However, the incidence of knee injuries can be decreased by enhancing balance and neuromuscular control. OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate how injury prevention programs (IPPs) that include balance training influence knee injury rates in athletes. METHODS: Data were obtained from different databases (1985–2021). Only randomised controlled trials that used IPPs that include balance training, were considered. Two investigators extracted data from the qualifying documents. The critical outcome data elements derived from the included studies were the number of ACL/knee injuries, ACL/knee injury rates, exposure hours, compliance rate, and follow-up duration. RESULTS: Compared to the control groups, those who participated in the IPP had a 54% lower risk of knee injuries per 1000 hours of exposure (IRR 0.457 (95% CI 0.346–0.603), P= 0.001) and a 60% lower risk of ACL injuries per 1000 hours of exposure (IRR 0.401 (95% CI 0.215–0.750), P= 0.004). CONCLUSIONS: IPPs that include balance training may reduce the risk of knee injuries.
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Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Hussain Ghulam
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Saud Al Arifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmed I. Alomar
- Department of Physical Therapy, Security Forces Hospital, Dammam, Saudi Arabia
| | - Saad Alhosaini
- Department of Physical Therapy, King Fahd Central Hospital, Jazan, Saudi Arabia
| | - Sami Alharbi
- Department of Physical Therapy, Medical Rehabilitation Hospital, Medina, Saudi Arabia
| | - Yasser Alraddadi
- Department of Physical Therapy, Medical Rehabilitation Hospital, Medina, Saudi Arabia
| | - Ross H. Sanders
- Discipline of Exercise and Sport Sciences, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
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Asgari M, Alizadeh MH, Shahrbanian S, Nolte K, Jaitner T. Effects of the FIFA 11+ and a modified warm-up programme on injury prevention and performance improvement among youth male football players. PLoS One 2022; 17:e0275545. [PMID: 36264894 DOI: 10.1371/journal.pone.0275545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction The 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 methods Three 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. Results Injury 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. Discussion Mid-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.
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Al Attar WSA, Bizzini M, Alzahrani H, Alarifi S, Ghulam H, Alyami M, Alzhrani M, Sanders RH. The FIFA 11+ Kids Injury Prevention Program Reduces Injury Rates Among Male Children Soccer Players: A Clustered Randomized Controlled Trial. Sports Health 2022; 15:397-409. [PMID: 35903029 PMCID: PMC10170224 DOI: 10.1177/19417381221109224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The 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. HYPOTHESIS It 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 DESIGN A clustered randomized controlled trial. LEVEL OF EVIDENCE Level 1. METHODS A 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. RESULTS A 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. CONCLUSION The FIFA 11+ Kids program reduced overall injury rates in children playing soccer more than the usual warm-ups. CLINICAL RELEVANCE The 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.
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Patti A, Giustino V, Cataldi S, Stoppa V, Ferrando F, Marvulli R, Farì G, Neşe ŞF, Bianco A, Muscella A, Greco G, Fischetti F. Effects of 5-Week of FIFA 11+ Warm-Up Program on Explosive Strength, Speed, and Perception of Physical Exertion in Elite Female Futsal Athletes. Sports (Basel) 2022; 10:sports10070100. [PMID: 35878111 PMCID: PMC9322867 DOI: 10.3390/sports10070100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Futsal is a sport that originates from soccer and is increasingly practiced all over the world. Since training and warm-up protocols should be sport-specific in order to reduce injuries and maximize performance, this study aimed to evaluate the effects of 5 weeks of the FIFA 11+ warm-up program on explosive strength, speed, and perception of physical exertion in elite female futsal athletes. Twenty-nine elite female futsal athletes participating in the Italian national championships were divided into two groups: the experimental group (EG) underwent 5 weeks of the FIFA 11+ warm-up program, and the control group (CG) underwent 5 weeks of a dynamic warm-up. We evaluated any effect on explosive strength (by Squat Jump test), speed (by Agility T-test), and perception of physical exertion (by Borg CR-10 scale). All measurements were carried out by a technician of the Italian Football Federation before (T0), at the middle (T1), and at the end (T2) of the protocol. The EG showed significant improvements on performances between T0 vs. T1 and T0 vs. T2 both in the Squat Jump test (p = 0.0057 and p = 0.0030, respectively) and in the Agility T-test (p = 0.0075 and p = 0.0122). No significant differences were found in the Squat Jump test performances in the CG, while significant improvements were detected in the Agility T-test performances (p = 0.0004 and p = 0.0053, T0 vs. T1 and T0 vs. T2, respectively). As for the Borg CR-10 scale, we found a significant difference between T0 and T2 in the EG (p = 0.017) and no differences in the CG. This study showed that 5 weeks of the FIFA 11+ warm-up program improves the jumping performance of female futsal athletes without adversely affecting speed. These findings can be useful for coaches and athletic trainers in order to consider FIFA 11+ warm-up program also in female futsal athletes.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (A.P.); (V.G.); (A.B.)
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (A.P.); (V.G.); (A.B.)
| | - Stefania Cataldi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy; (F.F.); (R.M.); (G.G.); (F.F.)
- Correspondence:
| | - Vito Stoppa
- FIGC Italian Football Federation, Puglia Regional Committee—Futsal Division, 70124 Bari, Italy;
| | - Federica Ferrando
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy; (F.F.); (R.M.); (G.G.); (F.F.)
| | - Riccardo Marvulli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy; (F.F.); (R.M.); (G.G.); (F.F.)
| | - Giacomo Farì
- Department of Biological and Environmental Science and Technologies, University of Salento, 73100 Lecce, Italy; (G.F.); (A.M.)
| | - Şahin Fatma Neşe
- Department of Sport and Health, Faculty of Sport Sciences, Ankara University, 06830 Ankara, Turkey;
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (A.P.); (V.G.); (A.B.)
| | - Antonella Muscella
- Department of Biological and Environmental Science and Technologies, University of Salento, 73100 Lecce, Italy; (G.F.); (A.M.)
| | - Gianpiero Greco
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy; (F.F.); (R.M.); (G.G.); (F.F.)
| | - Francesco Fischetti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy; (F.F.); (R.M.); (G.G.); (F.F.)
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Al Attar WSA, Ghulam HS, Al Arifi S, Akkam AM, Alomar AI, Sanders RH. The effectiveness of injury prevention programs that include core stability exercises in reducing the incidence of knee injury among soccer players: A systematic review and meta-analysis. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The knee is one of the most common sites of injuries among soccer players. The incidence of knee injuries can be reduced by improving the neuromuscular control and core stability. OBJECTIVE: This study aimed to evaluate the effectiveness of injury prevention programs that include core stability exercises in reducing the incidence of knee injuries among soccer players. METHODS: Data were obtained from different databases (1985–2021). Only randomized controlled trials that used injury prevention programs that include core stability exercise to prevent knee injuries were included. The keywords used during the search were ‘knee injuries’, ‘core stability exercises’, ‘FIFA 11+’, ‘prevention of knee injuries’, ‘anterior cruciate ligament injury’ and variations of these search terms. RESULTS: The pooled results of 7828 soccer players and 863700 exposure h showed an overall injury reduction of 56% per 1000 h of exposure in the intervention group compared to the control group with an injury risk ratio of 0.44 (95% CI 0.321–0.619; P= 0.001). CONCLUSIONS: Injury prevention programs that include core stability exercises reduce knee injury rates among soccer players by 56% (46% in male and 65% in female soccer players).
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Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Science, Umm Al Qura University, Makkah, Saudi Arabia
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Hussain S. Ghulam
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Saud Al Arifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Amirah M. Akkam
- Department of Physical Therapy, Faculty of Applied Medical Science, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy, King Fahd Central Hospital, Jazan, Saudi Arabia
| | - Ahmed I. Alomar
- Department of Physical Therapy, Security Forces Hospital, Dammam, Saudi Arabia
| | - Ross H. Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia
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Fujisaki K, Akasaka K, Otsudo T, Hattori H, Hasebe Y, Hall T. Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial. Trauma Care 2022; 2:238-50. [DOI: 10.3390/traumacare2020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - João Espregueira-Mendes
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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13
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Ripley NJ, Cuthbert M, Ross S, Comfort P, McMahon JJ. The Effect of Exercise Compliance on Risk Reduction for Hamstring Strain Injury: A Systematic Review and Meta-Analyses. Int J Environ Res Public Health 2021; 18:11260. [PMID: 34769778 PMCID: PMC8583500 DOI: 10.3390/ijerph182111260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/21/2023]
Abstract
Eccentric strength training can reduce the risk of hamstring strain injury (HSI) occurrence; however, its implementation can be impacted by athlete compliance and prescription. The aim of this review was to investigate the effects of intervention compliance, consistency and modality, on the prevention of HSIs among athletes. A literature search was conducted. 868 studies were identified prior to the application of the exclusion criteria which resulted in 13 studies identified. Random effects models were used to produce log odds ratios and 95% confidence intervals. Very high (>75.1%), moderate-high (50.1-75%), low-moderate (25.1-50%) and very low (<25%) and <1-, 1.01-3.00-, >3.01-weeks/session were used as thresholds of compliance and consistency, respectively. Modality was also observed. A positive effect on HSI incidence -0.61 (-1.05 to -0.17), favoring the intervention treatments (Z = -2.70, p = 0.007). There were non-significant, large differences between compliance (p = 0.203, Z = -1.272) and consistency (p = 0.137, Z = -1.488), with increased compliance and consistency showing greater effectiveness. A significant difference between intervention modalities was observed (p < 0.001, Z = -4.136), with eccentric interventions being superiorly effective. Compliance of >50.1% and consistent application with <3 weeks/session having positive effects on HSI incidence. Training interventions that can achieve high levels of compliance, and can be consistently performed, should be the objective of future practice.
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Affiliation(s)
- Nicholas Joel Ripley
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
| | - Matthew Cuthbert
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- The FA Group, St George’s Park, Burton-upon-Trent, Staffordshire DE13 9RN, UK
| | - Steven Ross
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk L39 4QP, UK
| | - Paul Comfort
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett, Leeds LS1 3HE, UK
| | - John James McMahon
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
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Swart JJW, Olivier B. Effectiveness of exercise interventions to prevent shoulder injuries in athletes: a systematic review protocol. JBI Evid Synth 2021; 19:2847-2856. [PMID: 34054035 DOI: 10.11124/jbies-20-00465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This review will evaluate the effectiveness of exercise intervention versus no intervention or alternate intervention to prevent shoulder injuries in athletes. INTRODUCTION Injury-prevention research has proven the effectiveness of exercise in preventing sports injuries in general and in the lower limb specifically. However, the results have been extrapolated to sport-related shoulder injuries from limited evidence. Similar reviews have been faced with insufficient high-quality evidence and limited studies due to restrictive target populations, resulting in reduced generalizability. INCLUSION CRITERIA Peer-reviewed randomized controlled trials, with adequate control arms, investigating shoulder-injury events after exercise intervention in athletes, both training or competing in sports, will be included. Studies with substitute end points for injury events and non-self-propelled athletes, or vehicle-assisted athletes, will be excluded. METHODS A comprehensive search of multiple databases will be used to find relevant studies. The databases will be searched from inception to April 2021, with no language restrictions imposed. Keywords and derivatives of "sport," "exercise intervention," "prevention," "shoulder injury," and "randomized controlled trials" will be used.Sources will include Academic Search Ultimate (EBSCO), CINAHL Plus (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), MasterFILE Premier (EBSCO), MEDLINE (PubMed), Physiotherapy Evidence Database (PEDro), ProQuest Health and Medical Complete and Nursing and Allied Health Source (ProQuest Complete), ScienceDirect (Elsevier), Scopus (Elsevier), SPORTDiscus (EBSCO), and Web of Science (Clarivate Analytics). Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020204141.
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Affiliation(s)
- Johannes Jacobus Wessel Swart
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Benita Olivier
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,The Wits-JBI Centre for Evidenced-Based Practice: A JBI Affiliated Group, Johannesburg, South Africa
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Krug MI, Vacek PM, Choquette R, Beynnon BD, Slauterbeck JR. Compliance and Fidelity With an Injury Prevention Exercise Program in High School Athletics. Sports Health 2021; 14:483-489. [PMID: 34490822 DOI: 10.1177/19417381211043120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Use of injury prevention programs (IPPs) by high school athletes has increased but their success in reducing injury depends on program compliance and fidelity of exercise performance. HYPOTHESIS Compliance with the 11+ IPP and exercise performance fidelity by high school athletic teams depend on sex, sport, and level of play. STUDY DESIGN Secondary analyses of data from a randomized controlled trial (RCT). LEVEL OF EVIDENCE Level 2. METHODS The 11+ IPP was implemented by 100 male and female high school athletic teams (American football, soccer, basketball, and lacrosse). Team compliance and fidelity with the program were evaluated by direct observation of warm-up routines and a weekly online survey completed by coaches. Differences in compliance and fidelity due to sport, sex, and level of play were assessed by analysis of variance. RESULTS Coaches reported that their teams performed the full IPP an average of 1.45 times per week, and 28% of observed warm-ups included all exercises in the IPP. Compliance differed by sport but not by level of play or the athletes' sex. At the end of the season, cueing was observed 19% of the time and differed by sport. Good technique was observed 66% of the time and varied by level of play. CONCLUSION Team compliance with the IPP varied by sport and was below the recommended number of sessions per week needed to reduce injury. Removal of implementation barriers and improved support from coaches are needed at all levels of play for IPPs to be effective. CLINICAL RELEVANCE Clinical and sports practitioners intending to implement an IPP at the high school level should anticipate and address barriers that affect program compliance and fidelity of exercise performance. Frequent follow-up and instruction may be necessary for successful adoption of the IPP.
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Affiliation(s)
- Mickey I Krug
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Pamela M Vacek
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont
| | - Rebecca Choquette
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Bruce D Beynnon
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - James R Slauterbeck
- McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont
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Al Attar WSA, Faude O, Bizzini M, Alarifi S, Alzahrani H, Almalki RS, Banjar RG, Sanders RH. The FIFA 11+ Shoulder Injury Prevention Program Was Effective in Reducing Upper Extremity Injuries Among Soccer Goalkeepers: A Randomized Controlled Trial. Am J Sports Med 2021; 49:2293-2300. [PMID: 34138672 DOI: 10.1177/03635465211021828] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Soccer is one of the most popular sports worldwide. Goalkeepers are more likely to injure their upper limbs, particularly their shoulders, than outfield players. To reduce upper extremity injuries, the FIFA 11+ Shoulder Injury Prevention Program (FIFA 11+S) was developed. PURPOSE The purpose of this study was to assess the effectiveness of the FIFA 11+S program in reducing the incidence of upper extremity injuries among amateur soccer goalkeepers. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 726 goalkeepers, who were blinded to study intent, were randomly assigned to the experimental group (n = 360) or control group (n = 366). The experimental group was instructed to perform the FIFA 11+S program before all training sessions for 1 season (6 months). The control group was instructed to continue performing their usual routine warm-up program before training sessions for 1 season. Primary outcomes included the incidence of upper extremity injury and incidence of mechanism, type, and severity of injury measured using injury risk ratios (IRR); compliance with the experimental and control interventions was also recorded. RESULTS A total of 50 injuries (0.62 injuries per 1000 exposure-hours) were reported in the experimental group, and 122 injuries (1.94 injuries/1000 hours) were reported in the control group. The FIFA 11+S program reduced the total number of upper extremity injuries by 68% (IRR = 0.32 [95% CI, 0.27-0.34]) compared with the usual warm-up. The FIFA 11+S program reduced the incidence of contact injury (IRR = 0.30 [95% CI, 0.25-0.31]), noncontact injury (IRR = 0.40 [95% CI, 0.35-0.43]), initial injury (IRR = 0.34 [95% CI, 0.29-0.36]), recurrent injury (IRR = 0.20 [95% CI, 0.17-0.21]), and overuse injury (IRR = 0.40 [95% CI, 0.35-0.43]). Participants in the experimental group demonstrated a significant decrease in injuries of minor (IRR = 0.32 [95% CI, 0.27-0.34]) and moderate severity (IRR = 0.33 [95% CI, 0.29-0.35]) compared with the control group. We noted no difference in compliance between the experimental and control groups (80% vs 73%, respectively; P = .92). CONCLUSION The FIFA 11+S program resulted in 50% fewer upper extremity injuries among soccer goalkeepers, compared with a regular warm-up. REGISTRATION ACTRN12618001080213 (Australian New Zealand Clinical Trials Registry).
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia.,Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Mario Bizzini
- Human Performance Lab, Schulthess Clinic, Zürich, Switzerland
| | - Saud Alarifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Raed S Almalki
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Riyadh G Banjar
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia
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Snodgrass SJ, Ryan KE, Miller A, James D, Callister R. Relationship between Posture and Non-Contact Lower Limb Injury in Young Male Amateur Football Players: A Prospective Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph18126424. [PMID: 34198516 PMCID: PMC8296252 DOI: 10.3390/ijerph18126424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022]
Abstract
Posture, a potentially modifiable injury risk factor, is considered important in injury screening/prevention in athletes, yet few studies investigate relationships between posture and injury. This prospective cohort study investigated whether static posture is associated with lower limb injury risk in male football players (n = 263). Nine aspects of static standing posture (left and right rearfoot, knee interspace, lateral knee, lumbar lordosis, thoracic kyphosis, scoliosis S and C, forward head) were assessed from photographs during the pre-season using the modified Watson and Mac Donncha scale, which was dichotomised for analysis (deviated or normal). Player characteristics (age, height, mass, body mass index, competition level), match/training exposure, and previous and in-season non-contact lower limb injuries were recorded. Binary logistic regression investigated relationships between posture and injury (previous and in-season). Eighty previous and 24 in-season lower limb injuries were recorded. Previous injury was not associated with any postural variable. In-season injury was associated with previous injury (OR = 3.04, 95% CI 1.20-7.68, p = 0.02) and having a normal thoracic curve compared to kyphosis (OR = 0.38, 95% CI 0.15-1.00, p = 0.05) but no other postural variables. Static postural deviations observed in male football players in the pre-season are not typically associated with non-contact lower limb injury risk; thus, they are unlikely to add value to pre-season screening programs.
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Affiliation(s)
- Suzanne J. Snodgrass
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (K.E.R.); (D.J.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- Correspondence:
| | - Kathleen E. Ryan
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (K.E.R.); (D.J.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Andrew Miller
- School of Education, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Daphne James
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (K.E.R.); (D.J.)
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia
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18
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Al Attar WSA, Bizzini M, Alkabkabi F, Alshamrani N, Alarifi S, Alzahrani H, Ghulam H, Aljedaani E, Sanders RH. Effectiveness of the FIFA 11+ Referees Injury Prevention Program in reducing injury rates in male amateur soccer referees. Scand J Med Sci Sports 2021; 31:1774-1781. [PMID: 33914964 DOI: 10.1111/sms.13983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/06/2021] [Accepted: 04/16/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The Fédération International de Football Association (FIFA) 11+ Referees Injury Prevention Program (FIFA 11+ Referees Program) is a structured warm-up program specially designed to prevent injuries in soccer referees. However, its effectiveness has yet to be fully documented in the literature. Therefore, the purpose of this study was to investigate the effectiveness of the FIFA 11+ Referees Program in reducing injury rates among soccer referees. METHODS A randomized controlled trial was conducted. Two hundred male amateur soccer referees (mean ± SD age, 31.6 ± 4.1 years) participated in this study. Participants were randomly allocated to the experimental and control groups. The experimental group performed the FIFA 11+ Referees Program as a warm-up during training sessions at least twice a week, and the control group performed their usual warm-ups. The participants were followed up for one season. The outcome measures were the incidence of overall injury, initial injury, recurrent injury, injury mechanism, and injury severity (primary), and the rate of adherence to the intervention program (secondary). RESULTS A total of 24 injuries were reported among 100 referees in the control group in 16 606 h of exposure (1.45 injuries/1000 exposure h), and a total of nine injuries were reported across 100 referees within the experimental group in 17 834 exposure h (0.50 injuries/1000 exposure h). The Injury Risk Ratio (IRR) was 0.35 (95% CI 0.26-0.45). CONCLUSION The results indicated that the FIFA 11+ Referees Program effectively reduced injuries in the experimental group by 65% compared to the control group.
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia.,Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW, Australia.,Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Mario Bizzini
- Human Performance Lab, Schulthess Clinic, Zürich, Switzerland
| | - Fahad Alkabkabi
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Nasser Alshamrani
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Saud Alarifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hussain Ghulam
- Department of Physical Therapy, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Eman Aljedaani
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Allois R, Niglia A, Pernice A, Cuesta-Barriuso R. Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial. J Bodyw Mov Ther 2021; 27:256-64. [PMID: 34391242 DOI: 10.1016/j.jbmt.2021.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recurrent ankle sprains are common in soccer players, characterized by restricted range of motion, pain, and decreased proprioception, strength, and postural control. The objective was to evaluate the effectiveness of a fascial therapy and strength training program, combined with kinesiotaping, in improving ankle range of motion, pain, strength and stability in footballers with recurrent sprains. METHOD A simple blind randomized clinical trial was conducted on soccer players. Thirty-six federated footballers were recruited and randomized to the two study groups. The experimental group received an intervention using myofascial techniques applied to the subastragaline joint, eccentric training with an isoinertial device and neuromuscular taping. The control group was administered an intervention using myofascial techniques on the subastragaline joint and eccentric training with an isoinertial device. The results were recorded for all players at baseline, after 4 weeks of intervention, and at the end of the 4-week follow-up period. RESULTS Subsequent to intervention and follow-up, we found statistically significant improvements in the experimental group in ankle mobility, strength and stability. The control group exhibited improvements in all study variables. No differences in the improvement of variables were found based on the allocation of athletes to one group or another. CONCLUSION The combination of fascial therapy and eccentric strength training with an isoinertial device improves ankle mobility, strength and stability in footballers with recurrent ankle sprains. The use of taping techniques failed to provide a greater improvement of the study variables when combined with manual therapy and strength techniques.
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Abstract
OBJECTIVES The purpose of this study was to integrate information about the effects of FIFA 11+ injury prevention program in soccer.DESIGN AND METHODS Systematic review. We used PubMed, Medline, PMC, and Web of Science to search randomized controlled trials comparing FIFA 11+ injury prevention program with control groups among soccer players.RESULTS Total of 13 studies was selected through eligibility criteria. 7 studies included overall, ankle, knee, and hamstring injury rate between FIFA 11+ versus control groups, while the other 6 studies included improvement of physical performance, such as vertical jump, 20m sprint, agility, hip adduction strength, and FMS total score between FIFA 11+ versus control groups. There was a lower rate of injury in the intervention group from all 7 studies. Couple of studies had different criteria to compare with other studies. Most values of physical performance were also significantly improved from all 6 studies except for the values of agility time.CONCLUSIONS Multiple studies have proven injury rate reduction and physical performance improvement of FIFA 11+ program between intervention and control groups. We also found that it at least required a few weeks of intervention time to be effective. Therefore, coaches and players might need to consider including FIFA 11+ program as a warm-up period to prepare the regular season.
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21
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Ishøi L, Krommes K, Husted RS, Juhl CB, Thorborg K. Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport - grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med 2020; 54:528-537. [PMID: 31937579 PMCID: PMC7212929 DOI: 10.1136/bjsports-2019-101228] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2019] [Indexed: 01/09/2023]
Abstract
This statement summarises and appraises the evidence on diagnosis, prevention and treatment of the most common lower extremity muscle injuries in sport. We systematically searched electronic databases, and included studies based on the highest available evidence. Subsequently, we evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework, grading the quality of evidence from high to very low. Most clinical tests showed very low to low diagnostic effectiveness. For hamstring injury prevention, programmes that included the Nordic hamstring exercise resulted in a hamstring injury risk reduction when compared with usual care (medium to large effect size; moderate to high quality of evidence). For prevention of groin injuries, both the FIFA 11+programme and the Copenhagen adductor strengthening programme resulted in a groin injury risk reduction compared with usual care (medium effect size; low to moderate quality of evidence). For the treatment of hamstring injuries, lengthening hamstring exercises showed the fastest return to play with a lower reinjury rate compared with conventional hamstring exercises (large effect size; very low to low quality of evidence). Platelet-rich plasma had no effect on time to return-to-play and reinjury risk (trivial effect size; moderate quality of evidence) after a hamstring injury compared with placebo or rehabilitation. At this point, most outcomes for diagnosis, prevention and treatment were graded as very low to moderate quality of evidence, indicating that further high-quality research is likely to have an important impact on the confidence in the effect estimates.
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Affiliation(s)
- Lasse Ishøi
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
| | - Kasper Krommes
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
| | - Rasmus Skov Husted
- Department of Orthopedic Surgery and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Carsten B Juhl
- Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
- Department of Orthopedic Surgery and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark
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Lago-Fuentes C, Jiménez-Loaisa A, Padrón-Cabo A, Mecías-Calvo M, Rey E. Perceptions of the technical staff of professional teams regarding injury prevention in Spanish national futsal leagues: a cross-sectional study. PeerJ 2020; 8:e8817. [PMID: 32257644 PMCID: PMC7102501 DOI: 10.7717/peerj.8817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 02/27/2020] [Indexed: 11/30/2022] Open
Abstract
Futsal is a sport with increasing popularity and level of performance, both in male and female categories. Also, there are several injuries along a season, so it is needed to know how to reduce this burden. The purpose of this study was to describe the perceptions of technical staff on injury risk factors, risk testing and preventive measures, and the strategies used by them within professional male and female futsal teams. A cross-sectional study was designed during the 2017–2018 season. A total of 32 futsal teams involved in male and female Spanish national futsal leagues completed, through an online survey platform, a questionnaire about injury risk factors, risk testing and preventive measures. Findings showed that: (a) most teams reported enough human resources, but insufficient material and time resources, (b) the main risk factors detected were previous injuries, strength deficits and dehydration, (c) functional movement patterns, flexibility tests and self-report questionnaires were the most applied tests for detecting injury risks in their players and (d) most of the main preventive measures used by technical staff matched with the best valued by them. Technical staff defined properly the main risk factors in futsal performance, as well as they applied preventive strategies with scientific support. The information provided in this research could be of interest for sport scientists and technical staff when designing more accurate and efficient injury prevention programs in futsal.
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Affiliation(s)
- Carlos Lago-Fuentes
- Faculty of Education and Sport Sciences, Universidad de Vigo, Pontevedra, Spain.,Faculty of Health Sciences, Universidad Europea del Atlántico, Santander, Spain
| | - Alejandro Jiménez-Loaisa
- Department of Sport Sciences, Sport Research Center, Universidad Miguel Hernández de Elche, Elche, Spain
| | - Alexis Padrón-Cabo
- Faculty of Education and Sport Sciences, Universidad de Vigo, Pontevedra, Spain
| | - Marcos Mecías-Calvo
- Faculty of Health Sciences, Universidad Europea del Atlántico, Santander, Spain
| | - Ezequiel Rey
- Faculty of Education and Sport Sciences, Universidad de Vigo, Pontevedra, Spain
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Al Attar WSA, Alshehri MA. A meta‐analysis of meta‐analyses of the effectiveness of FIFA injury prevention programs in soccer. Scand J Med Sci Sports 2019; 29:1846-1855. [DOI: 10.1111/sms.13535] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 03/30/2019] [Accepted: 08/05/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, College of Applied Medical Sciences Umm Al Qura University Makkah Saudi Arabia
| | - Mansour Abdullah Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences Umm Al Qura University Makkah Saudi Arabia
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences University of Queensland Brisbane Queensland Australia
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Elerian AE, El-Sayyad MM, Dorgham HAA. Effect of Pre-training and Post-training Nordic Exercise on Hamstring Injury Prevention, Recurrence, and Severity in Soccer Players. Ann Rehabil Med 2019; 43:465-473. [PMID: 31499600 PMCID: PMC6734023 DOI: 10.5535/arm.2019.43.4.465] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/28/2019] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the effect of adding Nordic exercise as post-training in decreasing hamstring initial, recurrent injuries rates, and their severity. Methods In this randomly controlled trial study, 34 professional football players aged 21 to 35 years were randomly assigned into two groups (17 players each) from Sporting clubs at Alexandria, Egypt. For group one, Nordic hamstring exercise (NHE) was performed pre-training and post-training. For group two, NHE was only performed pre-training. The control group was the same team during the previous season. Length of the trial was 12 weeks. The Australian football association injury form was used to collect incidence of injuries for each subject in both groups. Results Pooled results based on total injuries showed that group one had significantly less hamstring initial injuries (92% less) than the previous season, while group two had 80% less initial injuries and 85% less recurrent injuries than previous season. Regarding the severity of injuries in term of mean number of absent days, it was 1 day for group one and 2.7 days for group two while it was 7.95 days for the previous season during total risk time of 116.3±13.2 and 117.6±5.7 exposure hours for group one and group two, respectively. Conclusion The use of NHE as a prevention protocol was effective in reducing all hamstring injuries with the use of NHE during pre-training and post-training having the greatest effect.
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Affiliation(s)
- Ahmed Ebrahim Elerian
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Mohsen M El-Sayyad
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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