How effective are F-MARC injury prevention programs for soccer players? A systematic review and meta-analysis.
Al Attar WS, Soomro N, Pappas E, Sinclair PJ, and Sanders RH. Sports Med. 2015. [Epub Ahead of Print].
Take Home Message: The FIFA 11+ is effective at reducing injuries in soccer players.
Injury prevention programs such as the FIFA 11 and FIFA 11+ are aimed at reducing injuries during sport. While F-MARC further developed the FIFA 11 program into the 11+ program, there remains conflicting evidence on their effectiveness. Therefore, Al Attar and colleagues completed a systematic review and meta-analysis to evaluate the efficacy of the F-MARC injury prevention programs (FIFA 11 and FIFA 11+ programs) among soccer players. Researchers completed a comprehensive literature search, which identified 4299 potential articles. They included articles if the studies were 1) randomized controlled trials or cohort studies, 2) included only soccer players, and 3) used an F-MARC injury prevention program. Articles were then screened by 2 reviewers who extracted data from 9 studies. Articles quality was assessed on a 12 points scale with > 8 points (60% or greater) considered high quality. Injuries were defined as an event that causes a player to not be able to completely participate in a match or training. Overall, 6 studies were cluster-randomized controlled trials, 2 cohort studies and 1 randomized controlled trials. Five of the 9 included studies were rated as high quality. The length of implementation of injury prevention programs ranged from 12 weeks to 1 year. A total of 1753 injuries were recorded. Athletes receiving an injury prevention program were 23% less likely to have an injury than athletes who did not. More specifically, the authors found the FIFA 11+ program effective (35% reduced risk of injury) while the FIFA 11 program was not (8% reduced risk of injury). The programs may be more effective among male than female soccer players (~30% versus ~22% reduced risk of injury).
Overall, the data presented in this systematic review and meta-analysis supports the FIFA 11+ injury prevention program as effective at reducing injuries amongst soccer athletes. This is of interest to clinicians as the FIFA 11+ is easily implemented and is effective. While this is encouraging we should be cautious about these results because the authors combined studies that are very different. For example, the control warm-ups varied (8 used warm-up programs, 1 used traditional dynamic warm-up), age varied (8 studies included youth players, 1 study included veteran players), 3 studies were not randomized trials, and compliance ranged from 52 to 100% (one studies did not report compliance data). This makes true comparison difficult. We should also keep in mind that these results only apply soccer athletes. Despite these limitations, clinicians should consider implementing an injury prevention program, like the FIFA 11+, among soccer athletes.
Questions for Discussion: What injury prevention programs have you implemented in your current practice? Have you tried the FIFA 11+ program?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban
Related Posts:Al Attar, W., Soomro, N., Pappas, E., Sinclair, P., & Sanders, R. (2015). How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis Sports Medicine DOI: 10.1007/s40279-015-0404-x