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  1. H Lindblom1,
  2. M Waldén2,
  3. S Carlfjord2,
  4. M Hägglund1
  1. 1Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  2. 2Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden


Background Neuromuscular training (NMT) has been shown to reduce injury rates in highly structured clinical trials. There is, however, a paucity of studies that evaluate implementation of NMT programmes in sports.

Objective To evaluate the spread and implementation of a NMT programme in female adolescent football three years after a randomised controlled trial (RCT).

Design Cross-sectional study using web-based questionnaires, based on the RE-AIM SSM (Reach, Effectiveness, Adoption, Implementation and Maintenance Sports Setting Matrix) framework.

Setting Female adolescent football in Sweden.

Participants Representatives for the Swedish Football Association (FA) and eight district FAs that participated in an RCT in 2009, all coaches (n=303) who participated in the RCT and all currently (season 2012) active coaches for female adolescent teams (n=496) within the same districts were contacted. The response rates were 100% (Swedish and district FAs), 57% (RCT coaches, n=173) and 36% (current coaches, n=179), respectively.

Interventions Not applicable.

Main outcome measurements Reach, perceived effectiveness, adoption, implementation and maintenance of the NMT programme.

Results The reach of the programme was high, 99% of RCT coaches (control group) and 91% of current coaches were familiar with it, and the programme was generally positively perceived. The adoption rate (usage) among current coaches was 74%. Regarding implementation, 75–77% of coaches reported programme modifications. Usage of the programme was fairly well maintained over time among RCT coaches. Formal or informal policies regarding the programme's implementation existed in the Swedish FA and in two district FAs. Among current coaches 87% reported no club routines for programme use.

Conclusions Reach and adoption of the NMT programme was high among coaches. However, the follow-up also identified low programme fidelity and lack of formal policies for its implementation and use in clubs and district FAs.

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