Article Text

Download PDFPDF

051 Implementing a school prevention program to reduce injuries through neuromuscular training (iSPRINT): a cluster-randomized controlled trial
  1. Carla van den Berg1,
  2. Carolyn Emery1,2,3,4,5,6,7,
  3. Sarah Richmond1,8,
  4. Luz Palacios-Derflingher1,3,
  5. Carly McKay9,
  6. Patricia K Doyle-Baker1,5,
  7. Megan McKinlay1,10,
  8. Clodagh Toomey1,4,6,
  9. Alberto Nettel-Aguirre1,2,3,4,5,
  10. Evert Verhagen11,
  11. Kathy Belton12,
  12. Alison K MacPherson1,13,
  13. Brent Hagel1,2,3,4,5
  1. 1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
  2. 2Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
  3. 3Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada
  4. 4Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
  5. 5O’Brien Institute for Public Health, University of Calgary, Calgary, Canada
  6. 6McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
  7. 7Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
  8. 8Public Health Ontario, Health Promotion, Chronic Disease and Injury Prevention, Calgary, Canada
  9. 9Department for Health, University of Bath, Bath, UK
  10. 10Ever Active Schools, Calgary, Canada
  11. 11Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, Netherlands
  12. 12School of Public Health, University of Alberta, Edmonton, Canada
  13. 13Department of Health Sciences, York University, Toronto, Canada


Background The effectiveness of neuromuscular training (NMT) programs in preventing injuries in youth sport is well documented, however there is little evidence on NMT programs delivered in school physical education (PE).

Objective To assess the effectiveness of iSPRINT, a NMT warm-up implemented in PE classes in reducing injuries and improving performance.

Design Cluster-randomized controlled trial.

Setting Junior high schools in Calgary, Canada.

Patients (or Participants) 1,067 students (12 schools; ages 11–16; 53.7% female).

Interventions (or Assessment of Risk Factors) Following a workshop, teachers delivered a 12-week NMT (6 schools) or standard-of-practice (6 schools) warm-up at the beginning of PE classes.

Main Outcome Measurements Validated injury surveillance included sport/recreational injuries resulting in time loss from activity or medical attention. Predicted-VO2max, vertical jump, and single-leg eyes-closed dynamic balance on foam pad were measured at baseline and 12-weeks. Multiple multilevel regression analyses (adjusting for previous injury and random effect by school and class) estimated injury incidence rate ratios (IRR) (Poisson regression considering interaction with sex) and mean changes in performance (linear regression).

Results iSPRINT was protective against all injuries (IRR=0.543, 95%CI; 0.295–0.998), lower extremity injuries (IRR=0.357, 95%CI; 0.159–0.799) and medically-treated injuries (IRR=0.289, 95%CI; 0.135–0.619) in girls but not boys (IRR=0.866, 95%CI; 0.425–1.766, 1.055, 95%CI; 0.404–2.753, and 0.639, 95%CI; 0.266–1.532; respectively). Mean baseline balance times (seconds) were similar between iSPRINT (7.4, SD+/-2.6) and control participants (6.9, SD+/-2.2). At 12-weeks mean balance time was greater in iSPRINT group (9.1 SD+/-2.6) than control (7.9, SD+/-6.5). The difference in mean change over 12-weeks favoured the iSPRINT group (1.2 seconds, 95%CI; 0.2–2.1). No between group differences were observed for changes in predicted-VO2max or vertical jump.

Conclusions An NMT program is effective in reducing injuries in girls and improving dynamic balance in all youth. This research informs the current standard-of-practice warm-up in youth PE. Future research should consider exercise fidelity differences between girls and boys.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.