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Effectiveness of a warm-up programme to reduce injuries in youth volleyball players: a quasi-experiment
  1. Evert Verhagen1,
  2. Ingrid Vriend1,
  3. Vincent Gouttebarge2,3,4,5,
  4. Ellen Kemler6,
  5. Jacqueline de Wit7,
  6. Daniel Zomerdijk1,
  7. Joske Nauta1
  1. 1 Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
  2. 2 Section Sports Medicine, University of Pretoria, Pretoria, South Africa
  3. 3 Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
  4. 4 Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, The Netherlands
  5. 5 Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
  6. 6 Dutch Consumer Safety Institute (VeligheidNL), Amsterdam, The Netherlands
  7. 7 Dutch Volleyball Federation, Utrecht, The Netherlands
  1. Correspondence to Professor Evert Verhagen, Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC Locatie VUmc, Amsterdam, 1081BT, The Netherlands; e.verhagen{at}


Objectives To establish the effectiveness of the ‘VolleyVeilig’ programme on reducing injury rate, injury burden and injury severity in youth volleyball players.

Methods We conducted a quasi-experimental prospective study over one season of youth volleyball. After randomisation by competition region, we instructed 31 control teams (236 children, average age 12.58±1.66) to use their usual warm-up routine. The ‘VolleyVeilig’ programme was provided to 35 intervention teams (282 children, average age 12.90±1.59). This programme had to be used during each warm-up before training sessions and matches. We sent a weekly survey to all coaches, collecting data on each player’s volleyball exposure and injuries sustained. Multilevel analyses estimated differences in injury rates and burden between both groups, and we used non-parametric bootstrapping to compare the differences in injury numbers and injury severity.

Results We found an overall reduction in injury rates of 30% for intervention teams (HR 0.72; 95% CI 0.39 to 1.33). Detailed analyses revealed differences for acute (HR 0.58; 95% CI 0.34 to 0.97) and upper extremity injuries (HR 0.41; 95% CI 0.20 to 0.83). Compared with control teams, the intervention teams had a relative injury burden of 0.39 (95% CI 0.30 to 0.52) and a relative injury severity of 0.49 (95% CI 0.03 to 0.95). Only 44% of teams fully adhered to the intervention.

Conclusion We established that the ‘VolleyVeilig’ programme was associated with reduced acute and upper extremity injury rates and lower injury burden and severity in youth volleyball players. While we advise implementation of the programme, programme updates to improve adherence are needed.

  • Athletic Injuries
  • Volleyball
  • Sporting injuries

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Twitter @Evertverhagen, @vgouttebarge

  • Contributors VG and EV drafted the design of this study. VG, EK and JdW led the development of the studied intervention. IV, JN and EV drafted the study protocol. IV, DZ, JN and EV conducted data collection. EV performed the analyses and drafted the manuscript. All authors supported interpretation of the data and provided their final approval of the manuscript. EV is this study’s guarantor and accepts full responsibility for the conduct of the study and the finished work.

  • Funding The study was funded by the Netherlands Organisation for Health Research and Development (ZonMw), grant number 536001009.

  • Competing interests EK was employed at the Dutch Consumer Safety Institute (VeiligheidNL). JdW was employed at the Dutch Volleyball Federation (Nevobo). VeiligheidNL and Nevobo own the 'VolleyVeilig' intervention.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

  • © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.