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.
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