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Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes
  1. Kristian Thorborg1,2,
  2. Kasper Kühn Krommes1,3,
  3. Ernest Esteve4,5,
  4. Mikkel Bek Clausen6,
  5. Else Marie Bartels7,
  6. Michael Skovdal Rathleff3,8,9
  1. 1Department of Orthopaedic Surgery, Sports Orthopedic Research Center—Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark
  2. 2Department of Physical Medicine and Rehabilitation—Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark
  3. 3Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  4. 4University School of Health and Sport Sciences, Universitat de Girona (EUSES-UdG), Carrer de Francesc Macia 65, Girona, Spain
  5. 5Sportclinic, Physiotherapy and Sports Training Center, Girona, Spain
  6. 6Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen N, Denmark
  7. 7The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
  8. 8Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
  9. 9Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
  1. Correspondence to Dr Kristian Thorborg, Department of Orthopaedic Surgery, Sports Orthopedic Research Center—Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, Copenhagen University, Kettegårds Allé 30, Hvidovre 2650, Denmark; kristianthorborg{at}hotmail.com

Abstract

Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+).

Design Systematic review and meta-analysis.

Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham intervention) among football players.

Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016.

Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio of 0.75 (95% CI 0.57 to 0.98), p=0.04, in favour of the FIFA injury prevention programmes. Secondary analyses revealed that when pooling the 4 studies applying the FIFA 11+ prevention programme, a reduction in the overall injury risk ratio (incidence rate ratio (IRR) 0.61; 95% CI 0.48 to 0.77, p<0.001) was present in favour of the FIFA 11+ prevention programme. No reduction was present when pooling the 2 studies including the FIFA 11 prevention programme (IRR 0.99; 95% CI 0.80 to 1.23, p=0.940).

Conclusions An injury-preventing effect of the FIFA injury prevention programmes compared with controls was shown in football. This effect was induced by the FIFA 11+ prevention programme which has a substantial injury-preventing effect by reducing football injuries by 39%, whereas a preventive effect of the FIFA 11 prevention programme could not be documented.

Trial registration number PROSPERO CRD42015024120.

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Footnotes

  • Twitter Follow Kristian Thorborg @KThorborg

  • Contributors KT, KKK, MBC, EE, EMB and MSR all participated in the conception and design of the study. KT, KKK and EE were responsible for acquisition of data. MSR did the statistical analysis, and KT, KKK, MBC, EE and EMB took part in the interpretation of the analysis. KT drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version of the manuscript. KT is the guarantor.

  • Funding EMB is supported by the OAK foundation (grant number Ocay-07-264).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The statistical code and data set are available from the corresponding author.

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