Barengo NC, Meneses-Echavez JF, Ramierez-Velez R, Cohen DD, Tovar G, & Bautista JE. Int J Envrion Res Public Health. 2014. 11: 11986-12000.
Take Home Message: The FIFA11+ program reduced injuries and improved functional performance. It is more effective if compliance and adherence are high, both of which are better if a coach educated on the program administers the program to the team.
FIFA 11+ injury prevention program is an exercise program that can be easily incorporated into a team’s warm-up to help prevent sports injury. The exercises include core stability, proprioception, dynamic stability, and plyometric strengthening and only take less than 15 minutes to complete. The authors of this systematic review aimed to evaluate the effectiveness of the FIFA11+ program in soccer players on injury risk and performance. Thirteen studies were included in the final analysis that involved a pre- and post-intervention analysis of outcomes in a soccer population. The 13 articles were then methodologically assessed with the Physiotherapy Evidence Database scale (randomized controlled trials) or the Critical Appraisal Skills Programme (cohort studies) and the authors eliminated one study due to low methodological quality. Injury incidence was investigated in 6 studies, where 4 reported a reduction in injuries while 2 reported no reduction in injury incidence. Both studies that showed no injury-prevention benefit only did the program once/week. The FIFA11+ program improved multiple performance outcomes in the 7 studies that reported these outcomes such as proprioception/balance, strength, jump height, and sprint speed pre- to post-intervention which could have direct implications for injury prevention. The authors of one of the included studies reported that higher compliance was associated with lower injury risk, and that adherence was better in teams that had a coach delivered/supervised the program.
This systematic review reinforces that the FIFA11+ program can be successful at reducing injuries, improving physical performance measures, and is best delivered by a coach because adherence and compliance are linked with decreased injury risk. These findings are specific for the soccer population, and we need to find out if this intervention program is as effective in other sporting populations. The authors interestingly point out that this type of program has a public health impact because sport injuries are expensive and preventing them could reduce healthcare costs. A program like this could also have a drastic help decrease the number of athletes with long-term negative outcomes from sport injury, such as osteoarthritis. It would be interesting to see what the player and coaches’ perceptions of the FIFA11+ program are. Many coaches are hesitant to dedicate practice time to such programs, but the authors confirm that we may be able to get coaches to “buy in” by continuing to show evidence of improved functional measures as well as the added benefit of injury reduction. This systematic review is further evidence that we should start implementing injury prevention programs with our teams. It may be helpful to get parents, coaches, and athletes to buy into the programs if we remind them that not only does the program reduce the risk of injury but also can improve performance.
Questions for Discussion: Do any of the sports teams that you work with utilize an injury prevention program? Are there any barriers that you might be able to identify in trying to get coaches to implement this type of a program?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban
Osteoarthritis Action Alliance’s Injury Prevention Working Group’s Brochures on Preventing ACL Injuries and Improving Performance