Sports Medicine Research: In the Lab & In the Field: Coaches Can Be a Part of Your Prevention Plan (Sports Med Res)


Wednesday, May 3, 2017

Coaches Can Be a Part of Your Prevention Plan

Coach-lead prevention programs are effective in reducing anterior cruciate ligament injury risk in female athletes: a number-needed-to-treat analysis.

Pfile KR and Curioz B. Scand J Med Sci Sports. 2017. [Epub Ahead of Print].

Take Home Message: Coach-led anterior cruciate ligament (ACL) prevention programs were as effective as ACL prevention programs led by both coaches and clinicians.

The efficacy of lower extremity prevention programs for young athletes is widely documented. However, we know little about the impact of the professional who implements a program. Many researchers pair clinicians and coaches together to deliver a program. If a coach alone is just as effective without a clinician then this could greatly improve the cost and feasibility of an injury prevention program. Therefore, Pfile and colleagues completed a systematic review and meta-analysis to assess whether a coach-lead program or a mixed leadership group (coaches and clinicians) is more effective at implementing an ACL injury prevention program. The authors completed a comprehensive literature search and screened articles for inclusion. They included articles if they were published in English, used both a preventative training program and control group, included female participants, described who led the training program, and reported ACL injury incidents and exposure data. The authors included 11 articles in the final analysis and evaluated the articles using the PEDro scale.  The quality of each article ranged from 2 to 7 points with a 10-point maximum. Five of the 11 articles were cluster randomized trials. Overall, the authors revealed that both coach-led and mixed leadership groups implemented a ACL injury prevention program effectively. The number of athletes needed to treat for benefit were ~120 in the mixed leadership programs and ~133 athletes in the coach-led programs.

Overall, the results of this study may interest clinicians because coach-led programs may be as effective as a mixed group led ACL injury prevention program. Hence, members of the coaching staff may be able to effectively administer an ACL prevention program. This could be especially helpful for clinicians with a large number of athletes to treat or those with limited time to supervise these programs. Importantly, all coaches that led these programs received some education/training on how to deliver these programs. Clinician should help ensure coaches receive adequate training before they administer these programs. It may also be beneficial to periodically monitor the program to ensure it is being administered correctly and communicate openly and clearly with coaches when adjustments to the program need to be made. It should also be noted though that this systematic review included nonrandomized studies and failed to find any randomized trials that directly compared coach-led vs mixed-leadership programs. Until more research can be completed, clinicians may consider having coaches implement an ACL prevention program after the coaches are trained to administer these programs.

Questions for Discussion: In your current position, do you administer ACL prevention programs? Would you consider having a coach deliver injury prevention programs for you?

Written by: Kyle Harris
Reviewed by:  Jeffrey Driban

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Kevin Shubow said...

Hi Kyle,

This is a very interesting article and one that I think really hits home for a lot of Athletic Trainers. When you begin to consider the limited time and the amount of athletes some Athletic Trainers must cover, it appears to be a no-brainer to collaborate with coaches to implement such injury prevention programs.

I appreciated that this article reviewed the female athlete because I'm afraid that sometimes these are the sporting teams that lose the most coverage due to the "more intensive" sports such as football.

I do agree that with periodical monitoring perhaps there should be more coach-led injury prevention programs. However, I believe cooperation with the coaching staff comes into play when you begin to consider possibly cutting into practice time to implement such injury prevention programs.

How would you recommend getting the coaching staff on board for such injury prevention programs?



Kyle said...


Thanks so much for the excellent comment. I think first and foremost, athletic trainers need to treat each coach and situation independently. Just because one coach does and excellent job and is very regimented about a program doesn't mean that all coaches will be. With that being said I think that this is perfect use for the pre-season coaches meeting. I think that if all coaches are given the same reasoning for implementing these types of programs as well as the same strategies for how and when to implement, coaches may be more likely to accept the challenge. Further, I think that if one or two coaches voice opposition, this is a great opportunity to address the benefits of an injury-prevention program and why it is in the coaches best interest for them to lead such a protocol. Not to mention, that in a group setting even the coaches that do not voice an opinion may have similar concerns given that they all coach at the same school or institution. Do you have such a meeting currently at your place of employment?


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